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Brian Muir, PhD
Highly-inquisitive team-leader with 11+ years of experience employing machine learning and statistics in the healthcare industry and in computational biology. Direct the forecasting of $10+ billion in pharmacy and medical claim expenses using advanced predictive models in R for Centene Corporation’s (Fortune 500) marketplace insurance LOB.
Education
University of California Riverside
Ph.D. in Evolution, Ecology & Organismal Biology
Riverside, CA
2016 - 2010
Boston College
B.S. in Biology, Psychology (Double Major)
Chestnut Hill, MA
2010 - 2006
Professional Experience
Director - Marketplace Forecasting
Centene Corporation / Actuarial Services
Chicago, IL
Current - May, 2020
Manager - Analytics & Reporting
Centene Corporation / Actuarial Services
Chicago, IL
May, 2020 - Jul, 2018
- Direct the development, implementation, and presentation of the forecast for medical expenses across 27 states using mixed-models regression.
- Lead a team of six actuaries and data analysts with diverse experience and backgrounds.
- Developed strong relationships with various technical and non-technical business partners by supporting analytics with team’s in-depth knowledge of company’s medical, pharmacy, provider, membership, health status, sales, and payment data.
- Present findings to leadership on member-segmented variances to forecast, financial impacts of COVID cost and deferral of services, and deep-dives into claims trends during monthly CFO financial briefings.
- Developed a member-level gross margin database detailing revenue and expense components across 40 targetable member characteristics that integrates disparate data sources using SQL/R. Deployed overlaying drill-down dashboard in RSConnect used widely across departments to identify risks and opportunities for member-segmented business actions.
- Identified and support an $8M annual initiative improving on risk adjustment code capture by data-mining pharmacy prior authorization data.
- Created stratified med-management targeting model based on interacting utilization and health status, disease management acceptance, and demographics.
- Developed a member-level gross margin database detailing revenue and expense components across 40 targetable member characteristics that integrates disparate data sources using SQL/R. Deployed overlaying drill-down dashboard in RSConnect used widely across departments to identify risks and opportunities for member-segmented business actions.
- Identified and support an $8M annual initiative improving on risk adjustment code capture by data-mining pharmacy prior authorization data.
Data Scientist I
Centene Corporation / Business Optimization
Chicago, IL
Jul, 2018 - Oct, 2017
Data Analyst II
Centene Corporation / Business Optimization
Chicago, IL
Oct, 2017 - Sep 2016
- Built and implemented a novel claims completion model using regression to estimate incurred-but-not-reported expenses prior to month end. Model is used for early-warning and to accelerate preparation of financial reporting and commentary.
- Developed a probabilistic outlier-detection model based on episodes of care that is used to highlight targets for quality and cost-saving initiatives.
- Designed enterprise’s primary care auto-assignment algorithm to optimally assign members to local providers identified as high-quality and low-cost.
- Devised Rx trends and top conditions interactive RMarkdown reports using automated commentary to highlight emerging trends in Rx utilization; present findings monthly to Pharmacy Directors of local health plans.
Research Experience
Graduate Research Assistant / Computational Biology
University of California Riverside
Riverside, CA
Sep, 2010 - Aug, 2016
- Analyzed large gene expression datasets with R (Bioconductor) using non-parametric statistical models.
- Performed statistical tests of codon evolution in cancer gene-sequence alignments using maximum likelihood models.
- Designed and directed a multi-year longitudinal experimental evolution study on fruit flies that employed advanced experimental design statistics. Oversaw 2 – 6 undergraduate volunteer research assistants per quarter.
- Taught 18 quarters of upper and lower division biology courses with up to 150 students per week. Mentored 2 – 6 undergraduate volunteer research assistants per quarter.
Publications and Presentations
The expression of tumour suppressors and proto-oncogenes in tissues susceptible to their hereditary cancers.
Muir, B. & Nunney, L. British journal of cancer, 113(2), 345-353.
N/A
2015
Peto’s paradox and the hallmarks of cancer: constructing an evolutionary framework for understanding the incidence of cancer.
Nunney, L. & Muir, B. Phil. Trans. R. Soc. B, 370(1673), 20150161.
N/A
2015
Presentations
Scientific Conferences
N/A
2014-2015
- International Biannual Evolution and Cancer Conference - Lightning Talk & Poster | 2015
- Evolution Conference - Talk | 2014
Exams & Awards
Exams
Society of Actuaries
N/A
2018-
- PA - Predictive Analytics | Jun 2019
- SRM - Statistics for Risk Modeling | Jan 2019
- P - Probability | Sep 2018
Awards
Research and Education
N/A
2010-2016
- GAANN Fellowship | U.S. Department of Education | 2016
- Outstanding Teaching Assistant | UCR Graduate Division | 2015
- Dissertation Year Fellowship Award | UCR | 2015
- Chancellor’s Distinguished Fellowship Award | UCR | 2010